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Analysis: How Children Cope With the Ongoing Trauma of War
Talk Of The Nation: June 23, 2002
 Children and War
NEAL CONAN, host:
This is TALK OF THE NATION. I'm Neal Conan in Washington.
In any war, children are victims. They can experience war directly with the loss of a parent, a sibling, a teacher. They can be kidnapped, forced to fight alongside adults and sometimes forced to kill. War can destroy their homes, their families and their way of life in a thousand different ways. Some scars you can see, others are psychological, spiritual and emotional. Even if relatively few children experience the violence and chaos of war directly, many others witness the killings, the amputations and the social destruction as it takes place around them.
You've heard some of their stories on our radio programs. Three voices now: a schoolgirl in Northern Ireland, a boy in Sarajevo and an Angolan mother.
SOUNDBITES OF PREVIOUS STORIES
Unidentified Girl: Please stop it and let us go to school and have a happy education, just to get back to the normal routine, like doing work and doing my homework and talking to my friends and stuff, 'cause I've missed all that.
Unidentified Boy: (Through Translator) Today when I got to school I heard a grenade explode and immediately hid in a doorway. I didn't dare come out because I was so afraid.
Unidentified Mother: (Through Translator) The enemy came into my village, and I had one child on my back and Eduardo(ph) at my side. They started shooting. First they shot my husband dead, then they shot my baby on my back dead. Finally, they shot Eduardo's arm off. He hasn't spoken a word since.
CONAN: This hour, we're talking about the psychological and social effect on the health and development of children who grow up in war. How does it affect them? How long? What happens when they grow up and have children of their own? Can peace make a difference? And conversely, can lingering anger fuel a new cycle of violence? And what about adults? Can they help themselves by helping their children deal with the effects of war?
Joining us now from our bureau in Jerusalem is NPR's Julie McCarthy. Hey, Julie.
JULIE McCARTHY (NPR News): Hi there, Neal.
CONAN: Before we get into a discussion of how wars affect kids--and one of the reasons we're doing this program is a remarkable piece you did last night on "All Things Considered," but before we go on to that, we want to get an update on the missile attack last night that killed the military leader of Hamas and a number of children as well. What can you tell us about that?
McCARTHY: Well, the Israelis were after the founder of the military wing of Hamas, as you said, Salah Shehadeh. Israel holds him responsible--held him responsible for a network of suicide bombers who have turned Israeli society upside down with fear. They say he has been in their sights since the late 1980s, and the late-night strike collapsed his apartment block and killed him and his wife and children. Well over a hundred were wounded in the attack, and it's pretty clear it marks the resumption of Israel's controversial policy of targeted assassinations.
CONAN: That's certainly one thing, but there was also an account that we saw on the newswires here--I'm sure you're hearing it there--that Israeli officials said that their intelligence informed them that he and his family were alone and that there was not a crowded building with any number of other people around him.
McCARTHY: Well, the hospital is reporting, indeed, that there are other casualties, other fatalities. He may well have been the only one in that building, however there were other buildings as a result of that strike that were hit.
CONAN: I see. Now there is a huge reaction, from what we're hearing here, in the Palestinian community today, especially to the deaths of so many children.
McCARTHY: That's right. Well, first of all, the Israeli Defense Forces issued a statement expressing sadness and sorrow for the loss of the civilian life, but they said that terror can't be allowed to hide among what the Israelis call human shields, and the implication here is that Salah Shehadeh chose to expose his family by continuing to live among them all while carrying out the business of the military wing of Hamas. Prime Minister Ariel Sharon undoubtedly aggravated the Palestinian side by calling this one of the great successes in terms of taking out a man who tops the list of most wanted in Israel.
You're right, the Palestinians are enraged, not the least because of the children. Yasser Arafat called the strike an ugly crime and asked `Where was the international community, allowing this?' Palestinian officials believe that the attack was Ariel Sharon's way of torpedoing any political dialogue, because this kind of attack is going to inevitably invite retaliation. You had the White House conveying the message that the strike was heavy-handed, the EU and the United Nations deploring it as a failure to protect the lives of the innocent. So it's a familiar episode where Israel acts, the world condemns it. But now you've got the biggest demonstrations in years in Gaza and a vow for retribution, and the country is bracing itself tonight for another round of attacks.
CONAN: Well, if there's any news of those, of course, you'll hear it later on "All Things Considered" and throughout the evening, and more details of what happened last night and today on that program later.
But, Julie, the role of children is something that you've been reporting on. Last night on "All Things Considered" we heard your story about children on both sides of this conflict who lost their parents. I wonder, as you talked to people for that story, what left the strongest impression on you?
McCARTHY: I think the thing I found most compelling is that the children of this conflict have no space to heal. They don't go through the stages of grieving that healthy people are supposed to go through. There's no time in their lives for it. They're confronted with an onslaught of catastrophes to process. And this is true on both sides. An Israeli psychologist I talked to in the process of reporting that piece said the conflict inside Israel and the fear that it has generated of people becoming a victim of the attack, of children themselves becoming a victim of attack, is this heavy breath on your neck all the time. And for older children, a colleague of hers added that they are doubly afraid because they have to confront the reality that they're soon going to be going into the army.
Now for Palestinian children who live under Israeli occupation in the West Bank and the lockdown in Gaza, they face another kind of stomach-churning fear, you know, that around any corner an Israeli tank, a soldier can come with its turrets fixed on nothing special, but can cause, if not damage, huge anxiety. And a Palestinian psychologist who runs a counseling center here said with those kinds of continuous traumatic events, children are losing the ability to discern what is worth grieving over, which is a pretty profound thing to say. `Is it the loss of my mother? Is it my uncle losing his arm? Is it fear for my own life? What is it?'
In the occupied territories, the closures and the curfews do make it virtually impossible for social workers and psychologists to actually get to these kids.
CONAN: Now we're going to listen to some of the tape that you gathered for the story that did not make it into the piece as it aired last night. Tell us about the first cut of tape.
McCARTHY: This is Michelle Avadean(ph). She's 12 years old. She lost her father. He was killed in an Arab village where he routinely shopped. She said she was unusually close to him. She would talk to him about spats she had with her girlfriends. She remembers her father as a kind and decent man who went out of his way to help others, and here she is recollecting how she felt when he died.
SOUNDBITE OF INTERVIEW
MICHELLE AVADEAN: (Through Translator) At first, I did feel that it was like a national tragedy, but then the day after already, there were attacks every day, and it's like every day other Israelis were hit. And it was suddenly like everybody was under tragedy and all of Israel was all tragic.
CONAN: Julie, listening to that, it seems that this girl is drawing some comfort from the fact that she's not alone, she's not the only one suffering. Was that your impression?
McCARTHY: Yes, but she's also expressing an idea that worries the psychologist that I spoke with here, and that is the normalization of the situation--you know, that losing a parent, that children being raised by people other than their parents, that grandparents raising grandchildren is somehow a normal state of affairs now. It isn't normal. But the horrors of the conflict have made it so. And the psychologists are concerned about children growing up thinking this is normal, that this is somehow acceptable.
CONAN: Now, obviously, you reported from the other side as well. Tell us about your second piece of tape.
McCARTHY: This is a Palestinian child, Hassan Sari al-Ami(ph). He's 13. He is reciting a poem here by a Palestinian poet. This little boy lost his brother, who had secretly taken up the armed struggle. He was a stone thrower who graduated to a Molotov cocktail one night, and that night was shot dead by Israeli soldiers in his village of Beit Umar, outside of Hebron. Hassan is the younger brother. In the past year he's dedicated a lot of time to his brother's memory and paying homage to those who are clashing with the soldiers. And here's the poem he recited to me.
SOUNDBITE OF INTERVIEW
HASSAN SARI AL-AMI: (Through Translator) They drew the road for truth. They paved it with coral and with the hearts that--the young hearts full of truth. They raised their hearts and their hands, as red burning the stones, and they threw it at the monsters of the underroad. This is the time of being serious, so be serious.
CONAN: Julie, the type of vengeance that we heard that boy just talking about in that poem--how do his parents feel about that? Are they worried that he will follow his brother's path?
McCARTHY: Yeah. Very graphic, powerful stuff. I asked that of his father. You know, `their hearts in their hands as red burning stones, and they threw it at the monsters on the road'--it sounds--terribly radical stuff. And so when I asked this of his father, was he concerned at all about his son's choice of poetry, he was perplexed at the question and he said, `How could I disallow that? That's the reality. You can't block that out,' he said. `And as much as,' he said, `I don't want to lose another child to stone throwing at Israeli soldiers, we can't stop this version of reality from reaching them. It is their reality.'
And it is virtually impossible in the occupied territories to shield children from the militancy that is taking hold. In reporting that piece, I also found a singing summer camp where little girls were staging plays with songs that glorified the armed struggle and those who died in it. And when I asked the woman who ran the camp if she thought that was healthy, she said, `Healthy? No. But they won't hear anything else.' She brings ordinary songs, they don't want to sing them. These children appear to have been stripped of their innocence in many cases, and they will tell you that they have turned militant because, when you read between the lines, of fear, helplessness, a stripping of the dignity they see around them.
And I remember scribbling in my notebook on both sides--on both sides--`No one is smiling here.' These kids are all very serious.
CONAN: Well, when you talk about militancy, as you mentioned, there's a universal military service in Israel. Do Israeli parents have the same concerns for their children?
McCARTHY: Oh, certainly they are. They're worried that their children are growing up to hate Arabs. They're also worried about the symptoms that these kids are exhibiting. You know, they've got nightmares. They're wetting the bed. You've got adults here bedwetting. But they can talk about it. You know, one trauma expert said to me, `Well, that's OK, you know? They can get it out. They can get it over with. Adults do that.' But the children just bottle this up, and on both sides there's so much pain, and there is a difficulty in trying to relate to the pain of the other side. And the Israelis don't see life in the occupied territories. The Israeli press doesn't go there, so there's little context to understand it. By the same token, the Palestinians are beamed virulent anti-Israeli broadcasts, which skews their vision as well. And these children are caught in the middle of all this.
But what I came away thinking, Neal, was that--my understanding was if they can get to these children physically and take the time to draw them out with music or dancing or drumming or talking, they can make tremendous progress.
CONAN: Well...
McCARTHY: But getting to them is the problem.
CONAN: Well, you did report, as you were talking about the efforts of adults to help these kids, that on the Palestinian side there was tremendous physical problem of actually reaching the children.
McCARTHY: That's right. I mean, the occupation really does literally cut them off, in addition to which, as one Palestinian trauma expert said to me, in traditional societies it's extremely difficult to get the adults to talk, never mind the children. It's this whole idea of--there's a lot of keeping things to yourself, because sharing doesn't get you what you want. They're not confident that people are acting in their best interests, and therefore, it's even more difficult to get them to open up.
For the Israelis, there's great stock placed in being resilient, at least for the adults, and in bearing up and in moving on. And so when kids go to school the next day after seeing a bombing, the teachers are unprepared to talk about this, so no one dares even discuss it. So without talking, one psychologist said she just worries about what kind of human beings these kids are going to grow up to be, what kind of partners, husbands, wives and fathers, if all this unprocessed anger and fear goes on.
CONAN: Julie McCarthy, thank you so much for joining us today.
McCARTHY: Thank you, Neal.
CONAN: NPR's Julie McCarthy speaking with us from our bureau in Jerusalem.
We're talking about kids and war today, not just in the Middle East but in other parts of the world where children have grown up in long-running conflicts. Regrettably, there is no shortage of examples--Bosnia, Northern Ireland, central and southern Africa, Vietnam, Laos and Cambodia, to cite just a few. Have you lived in those war-torn countries, seen what has happened to the children there? Have you worked in the Peace Corps or for a relief agency? Give us a telephone call, (800) 989-8255, (800) 989-TALK.
This is TALK OF THE NATION. Back after a short break.
SOUNDBITE OF MUSIC
CONAN: This is TALK OF THE NATION. I'm Neal Conan in Washington.
We're talking about how kids in war-torn countries like Bosnia, Somalia and Northern Ireland cope with the ongoing stress of conflict. What emotional toll does it take on kids? And as they grow up into adults, what is the effect then? How does it affect their ability to trust and form relationships? If you have a story or a question, give us a phone call, (800) 989-8255. Or send us e-mail, totn@npr.org.
And joining us now is Mike Wessells. He's a professor of psychology at Randolph-Macon College in Ashland, Virginia, also a psychosocial adviser for the Christian Children's Fund, a non-governmental agency that provides health, education and social services to more than four million children in 42 countries around the world. And he joins us now from the studios of the Virginia News Network in Richmond.
And welcome to TALK OF THE NATION.
Professor MIKE WESSELLS (Psychology, Randolph-Macon College): Thanks, Neal. It's a pleasure to be here.
CONAN: You were listening as we were playing tape and talking about the children growing up in the Middle East conflict. You've studied Angola. Did what you were hearing sound familiar?
Prof. WESSELLS: It sounded very familiar, the same pattern of normalization of violence, of ongoing chronic stress, loss, one loss and one grief piled on top of the other. In Angola the war raged on for some 40 years, and what we saw was that people didn't have any space to grieve. Oftentimes they weren't able to conduct their appropriate cultural rituals that they regard as crucial for healing. And in many cases, peace fell off the map. By that I mean that violence became so normal in the family, community and society that people literally stopped talking about peace.
If you ponder the implications of that, it means that we're raising whole generations that don't even have a vocabulary of peace, who've learned that violence is their primary instrument for handling destructive conflict, who've seen models of it repeatedly, and who've learned to view the world as a very dangerous place, suffered multiple traumas, and who are oriented towards gaining revenge or using violence to achieve their objectives.
One of the main things that goes on in these war-torn countries, like Angola, is oftentimes children can't meet their basic needs. They sometimes don't have education. Lots of times they go with the military because that's the only way that they have of getting food or health care. And so at the end of the violence, they come out carrying a gun, having no education or job training, and that then prepares them for a life of violence even after a cease-fire may have been signed.
CONAN: You write a lot, in looking at some of your research from--you were also in Sierra Leone and South Africa, as well as Angola, but particularly Angola. And one of the things that I found interesting about what you wrote--you wrote that trauma, at least in this context--that we see it in Western terms and that people in a society like Angola's see it differently. Can you explain?
Prof. WESSELLS: Yeah. Let me give you an example. We were working in a program through Christian Children's Fund on trauma, and our Angolan team encountered an 11-year-old girl whose home had been attacked and her parents had been killed. She had to run away. And when we first interviewed her, we thought that since she was exhibiting some symptoms of post-traumatic stress disorder, with all the nightmares and anxieties and inability to regulate emotion, that that was her main problem.
But she said that the biggest stress for her was she had to run away before she could bury her parents. In the local belief system, that means that the parents' spirits could not join the world of the ancestors. There was literally a breach between the world of the living and the ancestral world which governs everything that happens in the visible world. That was viewed as a source of misfortune and something that could cause ill health. And so in that context, it was the conduct of a burial ritual, conducted by a traditional healer, which would enable the girl to grieve fully and to achieve spiritual harmony.
What this indicates is that individualized models of mental health don't apply universally. Where the local belief system is steeped in spirituality, the wounds of war are often understood to be holistic, to be communal. And that means that individualized counseling and Western therapies may not be the treatment of choice. Instead, some local cultural rituals and resources may be more appropriate.
As a second example, an Angolan boy who had been abducted into soldiering killed someone, and he said that he was haunted at night by the spirit of the person he killed. He said, `The spirit talks to me and says, "Why did you do this to me?"' There again, he was believed to be spiritually polluted or contaminated by the unavenged spirit of the people he had killed, and it was impossible for this boy to return to his village without the conduct of a ritual of purification. And again, that ritual lies well outside Western psychology. It's not the kind of thing that many Western psychologists would believe in, but in the local belief system, that's necessary for re-establishing harmony between the living and the ancestral worlds.
And so Western interventions may be of value. Expressing, drawing, storytelling, song and dance are all very much part of CCF's work in Angola, but in addition, we work very hard to intermix some so-called traditional, or I prefer the term `local,' methods of healing that are based in the local cultural belief system.
CONAN: One of the most encouraging things, as I read the--well, you'll excuse me, but the rather gloomy results of research--but one of the most encouraging things I read was a project that you were involved in that engaged villages in building schools for their children, a project that not only obviously helped the children, but helped the adults as well. Tell us about that.
Prof. WESSELLS: Well, one of the fundamental aspects of helping children is to help adults, because the single most important part of helping children is to get them in the care of a caring, emotionally competent and available adult. But in war, oftentimes adults are upset, they're disoriented, they feel overwhelmed. Oftentimes poverty leads them to spend huge amounts of time gathering water, wood and shelter, food, and they don't have time for children. So one of the things that we try to do, first of all, is to get a focus on children.
Education and its value are widely recognized. By having communities begin a process of collective planning, a couple of interesting things happen. One is the community begins taking control over its circumstances, and that, in itself, helps to reduce feelings of being overwhelmed. Secondly, they become future-oriented, and that enables them to get into a context where they can be more planful about generating a positive environment for children.
But equally important, in war-torn countries, people need to see material improvements under very difficult circumstances, and as they see those improvements and as they collaborate in building schools, oftentimes they become more hopeful. And so material improvement, collective planning, taking control and having hope are all very much part of this communal process of recovery.
And in that project you mentioned, Neal, the role of CCF was very much facilitative. We provided materials, but the community provided the labor and did the planning. This is profoundly important. Charity doesn't help in these situations. What helps much more is empowerment, capacity building, respecting the resilience that's available locally and building upon that, so that people can heal and build positive lives.
CONAN: You wrote `literally erecting a monument.'
Prof. WESSELLS: Yeah, a monument to their own healing, a sort of testimony to the fact that now they can make transition from a situation of war to a situation of peace and development.
CONAN: Our phone number again is (800) 989-8255, (800) 989-TALK. Our e-mail address, totn@npr.org. Let's go now to Gordon, and he's on the line with us from Elk Rapids, Michigan.
GORDON (Caller): Hello. Can you hear me?
CONAN: Yes, Gordon. You're on the air.
GORDON: Oh, well, my question is, well, when I was in Vietnam, we built a 3rd Marine Division children's hospital and we just--it seemed like the correct thing to do for all the children in a war-torn country. It's not their fault. And I just thought, wouldn't it be a good idea if we occupy other countries, even for a short time, to perhaps help build a hospital?
CONAN: Well, Mike, what do you think?
Prof. WESSELLS: Well, my answer is yes, but the manner in which one builds it would help if it were participatory, encouraged a sense of empowerment and local ownership by local people.
GORDON: And...
Prof. WESSELLS: Sometimes structures that are built from outside get abandoned later on if there's not a sense of local ownership and if there's not a spirit of local people maintaining it. So I think to do it in a sense of partnership is the best approach.
CONAN: And I wonder--you were also working with the traditional healers of these villages--again, you know, Western psychologists might not be too familiar with purification rites, as you talked earlier. Would working with local healers cause any problems?
Prof. WESSELLS: I think working with local healers requires a cautious critical attitude. It's inadvisable to romanticize local approaches because every culture has its strengths and weaknesses, but my feeling is that if you approach local healers with respect and an attitude of learning and a willingness to test empirically the usefulness of their methods, they'll teach you.
One of the methods that was used to help purify former child soldiers was to have the young boy be cleansed in the following way: The healer would demarcate a sacred space into which bad spirits couldn't enter, and the boy in the context of that space would be washed and would breathe special leaves that were being burned that were believed to have spiritual properties in a sort of fumigation process. There was a lot of washing of the young person to help cleanse him, and typically there's an offering to the bad spirit, typically the sacrifice of an animal. But at the end of the ritual--and this is the interesting part--the boy stepped across a threshold and the healer announced to the entire village, `This boy's life as a soldier has ended and he now re-enters our village as a non-soldier.'
And in the boy's mind, he was now cleansed and in the minds of the community he was clean again and could be accepted back into local rhythms and into work and play and all the joys that a young person should experience. And that's profoundly important. So I think Western psychology could play a role in learning more about the efficacy of these methods and how to blend them with some Western methods.
CONAN: Gordon, I'm wondering--I know a lot of vets have gone back to Vietnam to look at some of the places where they were involved in the conflict. Have you gone back?
GORDON: Well, I'd love to go back to Vietnam. It's just about the most beautiful countries I've ever seen.
CONAN: When you were involved in building that hospital--I mean, you must have seen kids all around you all the time caught up in the maelstrom of this conflict.
GORDON: Oh, sure. Sure.
CONAN: Yeah.
GORDON: That's one of the reasons that we did this. We put all the money that we could collect and had the Seabees build it and everybody helped. It was a necessary thing. It was in the village of Quang Tri.
CONAN: In Quang--that's up north.
GORDON: Yes.
CONAN: OK. Gordon, thanks very much for the call. We appreciate it.
GORDON: Oh, you're quite welcome.
CONAN: OK. And this e-mail question we have from Robert in Miami, Florida. `Are there any rules of war that protect children as there are rules that protect prisoners of war?' Mike, are you aware of any particular--I know there are plenty of rules affecting, you know, civilians and non-combatants, but any particular rules of war on children?
Prof. WESSELLS: Well, there are rules under the UN Convention on the Rights of the Child and the optional protocol that was just passed earlier this year that bar the participation of young people under 18 years of age in military combat. And that's one of the most significant. And unfortunately, the difficulty's that a lot of these rules are respected by states, but most of the conflicts that we see today involve non-state actors as well. And those non-state actors oftentimes have a rather steady disregard for international law and for norms of warfare. So I think one of the big challenges for the international community is to try to build norms of respect with non-governmental agencies. And the offices of UNICEF, the United Nations Children Fund, and the office of Olara Otunnu, who's special representative to the secretary-general on Children in Armed Conflict, are doing a lot of work around the world on these issues.
CONAN: Mike Wessells, thanks very much for being with us today.
Prof. WESSELLS: My pleasure. Thank you.
CONAN: Mike Wessells is a professor of psychology at Randolph-Macon College in Ashland, Virginia, and psychosocial adviser for the Christian Children's Fund.
You're listening to TALK OF THE NATION from NPR News.
And joining us now from our bureau in New York is Larry Aber. For 10 years he ran the Columbia University's Project on Children and War, now director of the National Center for Children in Poverty, also at Columbia. And welcome to TALK OF THE NATION.
Mr. LARRY ABER (Columbia University): Thanks, Neal.
CONAN: Again, you've been listening to a lot of these stories through this hour. Does this all sound familiar to you?
Mr. ABER: It does sound familiar, ranging from Julie's, I think, very, very accurate and sobering description of reaction of children in the Middle East through Mike's descriptions of children elsewhere. The anecdotes fit the scientific research that's emerging.
CONAN: Hmm. Now you studied kids in El Salvador and Guatemala.
Mr. ABER: A network of researchers that I co-chaired studied children in...
CONAN: OK.
Mr. ABER: ...El Salvador, Guatemala, Lebanon, Kuwait, Mozambique.
CONAN: Well, let's get to a phone call that I think is going to be to this point. Joining us now is Christian, who's on the line with us from Boston, Massachusetts.
CHRISTIAN (Caller): Yes, good morning. I mean, good afternoon, gentlemen. Interesting topic. I grew up in Lebanon during the civil war in Beirut, and to a certain extent, you get used to the lifestyle, you know, during the civil war. For instance, we were divided east and west, Christians and Muslims, and so you live in your own environment. And during the day, it's a normal life. There's a lot of shelling and, you know, at night there is shelling and bombings. So during the daytime, it's normal life. People go to school and businesses are fine. And at night and afternoon, so people go to the bunker, and sometimes people go out to the clubs and the casinos are open and the beaches, and you get used to it.
CONAN: Were kids involved--I spent a fair amount of time in Northern Ireland as reporter, and kids almost as sport would start, you know, throwing stones at either the police, in that case, or at the other side, perhaps, in your case. Did that happen with you growing up?
CHRISTIAN: Of course. I mean, you have to defend yourself. And sometimes you are pushed to the extreme to carry a machine gun, because you know the government collapsed and there was no national army, so militias--you know, people's armies started to--people carry guns and bombs and grenades and, you know, people tell you it's normal, `If I don't do it, so there is no army,' you know. So you become like an alien. You follow the law of the jungle, basically.
CONAN: How do you think that this has affected you as you've, obviously, grown up?
CHRISTIAN: Well, I have been here more than 10 years in the US, and I went to college in Boston. And you see, for an outsider--I mean, for someone living in Europe or United States, it's become the unforgotten war. So it will become--you watch CNN or the news or CBS news or whatever, or media, and they'll tell you, `Oh, in Lebanon there was fighting between Christians and Muslims or in Syria, whatever.' It's very difficult for an outsider to understand the symptoms of conflict. So for me, for instance, now if I read an article or something, I get the sense--for instance, what happened in Bosnia and Sarajevo and the former Republic of Yugoslavia or even if I hear the problems right now between the Palestinians and the Israelis and, you know, the civil wars are very complex and very different to understand.
CONAN: Well, thanks very much for the call.
CHRISTIAN: You're welcome.
CONAN: We appreciate it.
And, Larry, you know, does it make a difference, I wonder, as you're listening to him talking about this conflict in Beirut that grew up--and we're running out of time in this segment. We'll discuss this after we get back, but I wanted to talk to you more about whether it makes a difference if you perceive that your side has won. We'll talk about that after we get back from a short break. We're talking about kids and war, and we'd like more of your input as well. Have you had experience with recent wars in Europe, Africa or Central America? Are you, like Christian who just called a moment ago, a child of war? Give us a call, (800) 989-8255, (800) 989-TALK. Or send us e-mail, totn@npr.org. We'll be back in a couple of minutes.
I'm Neal Conan. It's TALK OF THE NATION from NPR News.
ANNOUNCEMENTS
CONAN: This is TALK OF THE NATION. I'm Neal Conan in Washington.
Tomorrow at this time, a look back at the life of musicologist Alan Lomax, the man who reintroduced us to people like Woody Guthrie, Jelly Roll Morton and introduced us to Leadbelly. That's tomorrow on TALK OF THE NATION.
Today, we are talking about kids in war. Children living in war zones are at high risk for developing post-traumatic stress disorder and other emotional problems. What happens when these kids become adults, and what is being done to help them? We're speaking with Larry Aber, director of the National Center for Children in Poverty at Columbia University in New York and a former co-director of Columbia University's Project on Children and War.
And before we left, Larry, I wanted to ask you a question about national identity, whether religious or ethnic. How does that affect the way the kids experience war, and does being on what is perceived to be the winning side--how does that affect things?
Mr. ABER: Well, as Christian told you, his experience of the war in Lebanon was slightly surrealistic because things happened at night that seemed chaotic and terrifying, and during the days, things seemed rather normal. The larger point there is that the effects of war on children's development depends on a number of factors, including the level of social and economic development in the country and community when the war is taking place, the stage of development of the child, the nature of the child's specific exposure to war-related events and the kinds of things you just mentioned--the personal meaning, including children's identity.
So for instance, we've found in research in Kuwait that children who are highly identified with the Kuwaiti state--the more highly identified they were, the more vulnerable they were to the experiences of war. It affected their mental health more because, we hypothesize, that was a war in which Iraq invaded Kuwait and Kuwait was a weak and terrified nation. Other researchers report in the initial intifada in Palestine that the more actively involved children were in the intifada, the more identified they were with the Palestinian cause, the more buffered they were from the negative effects of exposure to war on their mental health. They actually became perhaps less depressed through involvement in the war. And so it's a very complex thing we're talking about.
CONAN: Our next caller is Vivica, who's on the line with us from Los Angeles.
VIVICA (Caller): Hello. Yes.
CONAN: Hi.
VIVICA: I'm a psychiatrist. I'm a child of war. I'm a Palestinian refugee. And I just wanted to say to children of war that I think the most important factor is the family unit. This is what helped me get through medical school and all my training. And I was a child of war who went through a lot of difficult times, but I think it's very important for children of war to find pride and courage and be honored by the pain that they're going through, because this really is the only thing that we can do, and it's a very important survival tool that they can have.
And sometimes really--I work now in the Middle East. I am working with Palestinian refugees in camps and everywhere. And really they are under curfew, they're unable to get out of their houses, sometimes they don't even have food to eat. But I think the pride and, as the previous speaker just mentioned, that they found people who are identified with the cause--and that does not mean giving in to two wrongs to make a right, but continue to be identified with the cause, which is a just cause, and be proud of the pain so as to be able to survive this chaos and to maintain one's sanity and to go on with creatively trying to develop one's life and career and creative development.
I really think what's going on in the Middle East is very tragic and that we all have to think of the other side for our own survival. I think it's very important for children and their families to think of the enemy if they want to think of that as a human being who's also hurting and everybody's hurting in the Middle East, of course some more than others.
CONAN: Sure.
VIVICA: But I think we have to be able to look at the other side as a human side, too, and try to find solutions and moderate political, economic solutions that will have a healthy impact.
CONAN: As a child of war yourself, Vivica, I mean, do...
VIVICA: I'm sorry. I can't hear you very well.
CONAN: I'm sorry. Excuse me. As a child of war yourself and as a psychiatrist as well, I mean, do you analyze your own flashbacks? I mean, how does this manifest itself?
VIVICA: Yes. Yes. I did analytic training myself, and it has really helped me pull myself together, put myself together, and help my patients and work through a lot of the trauma that I went through. I was one of the lucky ones--one of the lucky Palestinian refugees who's had a very good education in the United States, to which I'm very, very grateful. And now I'm taking that education and helping other people avoid falling in the trap of thinking that suicide bombing is in the only solution. And I've treated many patients who decided not to suicide bomb.
On the other note, I want to also explain that the political situation in the Middle East right now is such that people are finding no solutions. And that's why the international community, I think, has to intervene to offer solutions so that creative solutions can be offered. At our center in Bethlehem we are now trying to provide an income-generating solution for some of our patients so that they don't feel so desperate. We are encouraging the women to embroider and men other activities, because really literally people are dying of hunger and they really are dying of claustrophobia sometimes. They really just cannot leave their homes.
CONAN: Vivica, thanks very much for your call.
VIVICA: OK. So please, the international community, get involved. Thank you.
CONAN: OK. Appreciate the phone call.
VIVICA: All right. Bye.
CONAN: Larry, obviously someone like her with a lot of, you know, assistance, as she pointed out, survived. Are there long-term studies showing what happens when children of war become adults?
Mr. ABER: Tragically, no, not yet. And the reason I say tragically is because that scientific information could be of enormous benefit in shaping intervention programs and some of the culturally specific kind of programming that Mike Wessell's talked about. The international research community is organizing to try to study the effects of war on children in a more systematic way. We know much more about how many children have contracted HIV-AIDS, how many more children have tuberculosis. The scope and nature of the problem of physical disease is clearer to us than of the psychosocial effects of war.
But there is an action research network that is being organized. Mike mentioned Olara Otunnu, who's a special representative to the secretary-general at the UN on Children in Armed Conflict. His office, plus an international research society called the Social Science Research Council, are organizing to support researchers--both local researchers and international researchers--to team together to try to understand more.
What we do know is we can extrapolate some from other studies of the long-term effects of violence on children. And I mentioned earlier that the effects of war depends on several things, including the stage of development and the nature of exposure. I'll just give two examples. The younger children are--the more likely exposure to war will affect their basic trust in other human beings and will affect whether they interpret ambiguous situations as hostile in intent. Older children are developing their identity--their personal identity, their social and racial and national identities. So at different stages, war has different effects on children. We do know that the earlier and more extremely children experience violence, the more likely it is to affect literally their brain chemistry, in the case of PTSD, and in their ability...
CONAN: Post-traumatic stress disorder, yes.
Mr. ABER: Thank you. Sorry, Neal. And in their ability to confidently and resiliently create relationships with others, especially intimate relations where you have to manage close emotions, like marriages and parent-child relations.
CONAN: Well, Larry Aber, thanks very much for being with us today.
Mr. ABER: Thank you, Neal.
CONAN: Larry Aber is director of the National Center for Children in Poverty at Columbia University in New York, and he was speaking with us from our bureau in New York.
You're listening to TALK OF THE NATION from NPR News.
Joining us now is Arlene Healy, director of the Family Trauma Center in Belfast, Northern Ireland. And welcome to you.
Ms. ARLENE HEALY (Family Trauma Center, Belfast, Northern Ireland): Hi.
CONAN: Who comes to your center for help?
Ms. HEALY: We're a center that we see children and their families, children whose homes have been bombed, children who have been attacked or children whose parents have been killed.
CONAN: Now the troubles in Northern Ireland have been going on for 30 years and more now. Your center was set up in 1999.
Ms. HEALY: That's right. Yeah.
CONAN: Why did it take so long?
Ms. HEALY: Exactly what your other speakers have been saying. It's scary how normal this situation can become. I grew up in Northern Ireland through all of my years and it seemed quite normal. And psychologically we needed that sense of normality to cope. And research has really indicated that for our situation, really silence and distancing and denial, that's how we manage. So the government provided no services, people didn't look for them. They just tried to go about their work as normal.
CONAN: I wonder, too--obviously, Northern Ireland, a Western society, for much of the last 30 years I think there's an awful lot of Valium under the bridge.
Ms. HEALY: There certainly is. And during--I mean, now that we're moving into quite an advanced stage of the peace process, we have an increase in violent crime, an increase in alcohol abuse, an increase in domestic violence. Thirty years ago, we had the lowest crime rate in Europe and we had very few people in our prisons. And those kind of population figures now are just really soaring.
CONAN: Hmm. Now the issue that keeps coming up is safety. There's a story--I understand that you know about a little girl who went on a vacation to Scotland with her father.
Ms. HEALY: I was talking to your researcher and I was saying that it's such a common theme. She was asking how the situation affects children in Northern Ireland, and it's very difficult--we're, you know, three, four years into a peace process. That's what we're being told to expect. A lot of things have changed. Soldiers are off the streets. But in the interface areas and the most intensely affected areas there are frequent riots and there's a very difficult dispute there in the Holy Cross Girl's School. And one of the little girls that I was seeing there--again, suffering really quite serious symptoms of trauma--and her father took her to Scotland. And as soon as she got off the boat, she asked him, was this a Catholic country or a Protestant country? That would determine whether or not she felt safe.
CONAN: Hmm. Here's an e-mail that I wanted to ask you to respond to. This one from Sally in Cary, North Carolina. `I had the very impressive experience,' she writes, `of hearing the little girl from the Pulitzer Prize-winning photograph running naked down the street having been burned by napalm talk about her journey from hate and anger through many years to a place where she could at last forgive. And it not only healed her soul, but also her forgiveness brought healing to the pilot who had done that drop.' He had been told there were no civilians in that town.
Ms. HEALY: Yes.
CONAN: She now heads the KIM Foundation, which she founded, whose purpose is to help the children of war. I wonder, are you familiar with that, and what role does forgiveness play in all of this?
Ms. HEALY: I think myself, like lots of people, that image is very, very familiar and images of trauma, even if they're off a newspaper, stay so vividly in your mind. And so imagining what's that like for people who actually witness these events in real life, it leaves such a huge impact on them. And as your previous speaker was saying, if they're young children, the impact of that developmentally is really quite profound. And through our own work, we're really trying--like, I would agree very much with Vivica's statement about families and that she survived her situation and grew up because of the support that she had from within her family unit. And that's very much why we work with whole families, because a lot of the families we see would not have been families that normally would have sought out psychological services for their children. They're very well-functioning, well-managing families, but the families that we work with in war situations is the constant nature of the trauma. It's continuous. It's multiple. Not like a lot of other traumatic events, once it's over, then post-traumatic stress disorder can set in, whereas in our situation, it's constant.
CONAN: We just have a couple of minutes left. Let's see if we can get in one last call. This is Jim, who's on the line with us from Boston, Massachusetts.
JIM (Caller): Yes. My comment was I was in south Sudan in 1996 working with a relief organization. And I found that the children sort of just ignored what was going on around them, and played their little games with sticks and stones or whatever. And it just amazed me because amongst this little compound we were in, there were a lot of military people marching and grunting and it was a little bit horrible, but they themselves were able to just carry on.
CONAN: Is that an illusion to some degree, do you think, Arlene?
Ms. HEALY: I wonder really about dissociation sometimes as well, that children just learn some amazing capacity to switch off and, you know, imagining what the extent of that must be for children to play in such extreme circumstances. But that's what can happen under severe continuous trauma. You have to find some way to function in some basic capacity.
CONAN: Jim, thanks very much for that story.
JIM: You're welcome.
CONAN: And, Arlene Healy, thank you very much for joining us.
Ms. HEALY: Thank you. There was one positive thing I wanted to say. Quite a few people mentioned the work of Olara Otunnu, and he's visited Belfast as well. I've met with him from the UN and, I think, pulling together a lot of this knowledge and information, because it's quite appalling that the psychological health of children has been affected by trauma in war has been ignored for so long.
CONAN: Arlene Healy is director of the Family Trauma Center in Belfast, Northern Ireland. And she spoke to us very late there--we appreciate it...
Ms. HEALY: Have a good day.
CONAN: ...from her home in Belfast.
Ms. HEALY: OK. Goodbye.
CONAN: Goodbye.
In Washington, I'm Neal Conan, NPR News.
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